Recurrent lymphocytic meningitis or Mollaret's meningitis is a rare condition caused by a num... more Recurrent lymphocytic meningitis or Mollaret's meningitis is a rare condition caused by a number of infectious, autoimmune, toxic and neoplastic diseases. Herpes simplex type 2 is the most commonly isolated agent. It usually compromises middle aged women, with a self-limited clinical presentation that resolves within a week leaving no sequelae. Its diagnosis is mainly based on nucleic acid detection on cerebrospinal fluid. Antiviral prophylaxis has not shown conclusive to avoid recurrences.
Role of microbiology laboratory in the diagnosis of patients with suspected infections of CNS Jav... more Role of microbiology laboratory in the diagnosis of patients with suspected infections of CNS Javier Bava, Ruben Solari, Guillermina Isla, Maria Eugenia Bosco Borgeat, Alcides Troncoso Department of Infectious Diseases, Francisco J Muniz” Hospital, Buenos Aires, Argentina 2 Department of Mycology, ANLIS “Carlos Malbran”, Buenos Aires, Argentina 3 Department of Microbiology and Infectious Diseases, University of Buenos Aires, Buenos Aires, Argentina
The Journal of Infection in Developing Countries, 2008
The microscopic recognition of typical rounded capsulated yeasts in centrifuged cerebrospinal flu... more The microscopic recognition of typical rounded capsulated yeasts in centrifuged cerebrospinal fluid (CSF), stained with India ink, is a common, rapid and effective method for the diagnosis of cryptococcal meningitis among AIDS patients. The presence of atypical forms of Cryptococcus neoformans var. neoformans in samples of CSF of an AIDS patient with cryptococcosis treated at the University Hospital of Infectious Disease is presented. The India ink microscopy of three consecutive CSF samples revealed capsulated yeast with India ink particles in the deteriorated capsules and capsulated pseudohyophae. Clinically, the patient showed a subacute meningoencephalitis, with a clinical picture not particularly different from those commonly observed in patients with AIDS-associated cryptococcosis treated in our hospital. In all cases, the culture of the CSF showed colonies of C. neoformans with typical macro and micromorphology, and the in vitro susceptibility tests to amphotericin B, fluocitosine, itraconazole and fluconazole showed MIC values into the limits of sensitivity. The presence of atypical forms of C. neoformans, considered as an atypical finding, could be the consequence of an adaptive phenomenon of this fungal species to an impaired immunological status present in the host.
Enfermedades infecciosas y microbiología clínica, 2001
The study evaluates the incidence of ocular compromise in the Kaposi's sarcoma associated wit... more The study evaluates the incidence of ocular compromise in the Kaposi's sarcoma associated with AIDS. We revised the clinical histories of HIV seropositives patients seen in the ophthalmology department from January, 1994 to December, 1998. All patients were examined by direct visually and dilated fundus examination with the use of either a direct or an indirect ophthalmoscope. In 6,552 patients, ocular Kaposi's sarcoma was diagnosed in 17 (0.25%), predominantly in male sex (88.23%). The lesions predominated in eyelids, and the inferior has been the most affected. In only one female, the ocular compromise was the first neoplastic manifestation. The ocular compromise in the Kaposi's sarcoma is an alternative to be considered in AIDS patients with previous or simultaneous cutaneous or visceral involvement. Due to the few clinical signs of these lesions, a thorough ocular study is recommended in these patients.
Enfermedades infecciosas y microbiología clínica, 1998
Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which... more Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which has been described in only 25 published cases in the last 15 years. The appearance of serious disseminated forms of tuberculosis is enhanced by the severe immunodeficiency which characterizes AIDS. Four cases are described of disseminated tuberculosis with cutaneous localization clinically described as the acute miliary form. Patients had AIDS and CD4 lymphocyte levels of < 100 cells/mm3. Diagnosis was established in all cases by scraping of cutaneous lesions and direct examination with Ziehl-Neelsen coloration. The 4 patients presented signs and symptoms of disseminated tuberculosis with cutaneous manifestations, without a definite pattern and with localization predominantly on the thorax. Three had BAAR-positive sputum. Multiresistant strains of Mycobacterium tuberculosis were confirmed by antibiogram. One patient infected by a strain sensitive to first-line drugs responded favorab...
Histoplasmosis is an endemic and systemic mycosis, caused by the dimorphic fungus Histoplasma cap... more Histoplasmosis is an endemic and systemic mycosis, caused by the dimorphic fungus Histoplasma capsulatum var capsulatum. Disseminated disease in immunocompromised patients generally results from the reactivation of latent foci after a prolonged period of asymptomatic infection. We report a case of laryngeal histoplasmosis as the unique clinical manifestation of a progressive form of the disease in a patient with advanced HIV/AIDS disease. Histopathological analysis of laryngeal biopsy smears revealed granulomas containing Histoplasma-like organisms. Treatment with amphotericin B followed by itraconazole resulted in complete remission of laryngeal lesions. To our knowledge, this is the third case report of laryngeal histoplasmosis in a patient with AIDS.
Case report and literature review Malignant syphilis is a rare form of secondary syphilis strongl... more Case report and literature review Malignant syphilis is a rare form of secondary syphilis strongly associated with human immunodeficiency virus infection (HIV). This clinical form of the disease is characterized by atypical cutaneous ulcerative and disseminated lesions and systemic compromise that can delay the final diagnosis. There are only few reports in the medical literature about malignant lues in HIV-infected patients. Malignant syphilis should be considered in the differential diagnosis in HIV-infected patients with fever and ulcerative skin lesions. Here we describe a man who developed clinical cutaneous and systemic manifestations pathologically confirmed as malignant syphilis and we performed a review of the literature.
... Report of a case and review of the literature Rubén Solari 1 , Marcelo Corti 1 , Diana Cangel... more ... Report of a case and review of the literature Rubén Solari 1 , Marcelo Corti 1 , Diana Cangelosi 1 , Manuel Escudero 1 , Ricardo Negroni 2 ... are located in the United States along the Mississippi Valley, the Missouri and the Ohio Rivers and in South America, Serra do Mar in ...
Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the sk... more Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the skin with a wide range of clinical manifestations. Commonly, the clinical features of CBCL are plaques, nodules, or ulcerative lesions. Skin is one of the common sites for extra-nodal lymphomas in patients with AIDS and B cell type is less common than T cell type. Only recently, the existence of B cell lymphomas presenting clinically in the skin without evidence of extra-cutaneous involvement has been accepted as primary CBCL. Here, we are presenting 5 patients with cutaneous involvement in the setting of HIV/AIDS disease. Two of them were primary cutaneous non-Hodgkin lymphomas. All were CBCL; 3 were immunoblastic, 1 was plasmablastic, and the other was a Burkitt lymphoma. We analyzed the epidemiological, clinical, virological, and immunological characteristics of this group of patients.
Revista do Instituto de Medicina Tropical de São Paulo, 2008
Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last y... more Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.
Revista da Sociedade Brasileira de Medicina Tropical, 2007
Lymphomas of the oral cavity are a rare complication of advanced HIV/AIDS disease. The clinical a... more Lymphomas of the oral cavity are a rare complication of advanced HIV/AIDS disease. The clinical appearance of these neoplasms includes masses or ulcerative lesions that involve the oral soft tissue and the jaw as the predominant manifestation. We report the case of a patient with AIDS who developed diffuse large B-cell non-Hodgkin's lymphoma of the oral cavity during highly active antiretroviral therapy, with undetectable plasma viral load and immune reconstitution.
Extranodal non-Hodgkin lymphoma (NHL) were commonly described in AIDS patients and are related wi... more Extranodal non-Hodgkin lymphoma (NHL) were commonly described in AIDS patients and are related with an atypical morphology and aggressive clinical course.
Enfermedades Infecciosas y Microbiología Clínica, 2001
ABSTRACT The study evaluates the incidence of ocular compromise in the Kaposi’s sarcoma associate... more ABSTRACT The study evaluates the incidence of ocular compromise in the Kaposi’s sarcoma associated with AIDS. Methods We revised the clinical histories of HIV seropositives patients seen in the ophtalmologie departament from January, (1994) to December, (1998). All patients were examined by direct visually and dilated fundus examination with the use of either a direct or an indirect ophtalmoscope. Results In 6,552 patients, ocular Kaposi’s sarcoma was diagnosed in 17 (0.25%), predominantly in male sex (88.23%). The lesions predominated in eyelids, and the inferior been the most affected. In only one female, the ocular compromise was the first neoplasic manifestation. Conclusions The ocular compromise in the Kaposi’s sarcoma is an alternative to be considered in AIDS patients with previous or simultaneous cutaneous or visceral involvement. Due to the few clinical signs of these lesions, a thorough ocular study is recommended in these patients.
Recurrent lymphocytic meningitis or Mollaret's meningitis is a rare condition caused by a num... more Recurrent lymphocytic meningitis or Mollaret's meningitis is a rare condition caused by a number of infectious, autoimmune, toxic and neoplastic diseases. Herpes simplex type 2 is the most commonly isolated agent. It usually compromises middle aged women, with a self-limited clinical presentation that resolves within a week leaving no sequelae. Its diagnosis is mainly based on nucleic acid detection on cerebrospinal fluid. Antiviral prophylaxis has not shown conclusive to avoid recurrences.
Role of microbiology laboratory in the diagnosis of patients with suspected infections of CNS Jav... more Role of microbiology laboratory in the diagnosis of patients with suspected infections of CNS Javier Bava, Ruben Solari, Guillermina Isla, Maria Eugenia Bosco Borgeat, Alcides Troncoso Department of Infectious Diseases, Francisco J Muniz” Hospital, Buenos Aires, Argentina 2 Department of Mycology, ANLIS “Carlos Malbran”, Buenos Aires, Argentina 3 Department of Microbiology and Infectious Diseases, University of Buenos Aires, Buenos Aires, Argentina
The Journal of Infection in Developing Countries, 2008
The microscopic recognition of typical rounded capsulated yeasts in centrifuged cerebrospinal flu... more The microscopic recognition of typical rounded capsulated yeasts in centrifuged cerebrospinal fluid (CSF), stained with India ink, is a common, rapid and effective method for the diagnosis of cryptococcal meningitis among AIDS patients. The presence of atypical forms of Cryptococcus neoformans var. neoformans in samples of CSF of an AIDS patient with cryptococcosis treated at the University Hospital of Infectious Disease is presented. The India ink microscopy of three consecutive CSF samples revealed capsulated yeast with India ink particles in the deteriorated capsules and capsulated pseudohyophae. Clinically, the patient showed a subacute meningoencephalitis, with a clinical picture not particularly different from those commonly observed in patients with AIDS-associated cryptococcosis treated in our hospital. In all cases, the culture of the CSF showed colonies of C. neoformans with typical macro and micromorphology, and the in vitro susceptibility tests to amphotericin B, fluocitosine, itraconazole and fluconazole showed MIC values into the limits of sensitivity. The presence of atypical forms of C. neoformans, considered as an atypical finding, could be the consequence of an adaptive phenomenon of this fungal species to an impaired immunological status present in the host.
Enfermedades infecciosas y microbiología clínica, 2001
The study evaluates the incidence of ocular compromise in the Kaposi's sarcoma associated wit... more The study evaluates the incidence of ocular compromise in the Kaposi's sarcoma associated with AIDS. We revised the clinical histories of HIV seropositives patients seen in the ophthalmology department from January, 1994 to December, 1998. All patients were examined by direct visually and dilated fundus examination with the use of either a direct or an indirect ophthalmoscope. In 6,552 patients, ocular Kaposi's sarcoma was diagnosed in 17 (0.25%), predominantly in male sex (88.23%). The lesions predominated in eyelids, and the inferior has been the most affected. In only one female, the ocular compromise was the first neoplastic manifestation. The ocular compromise in the Kaposi's sarcoma is an alternative to be considered in AIDS patients with previous or simultaneous cutaneous or visceral involvement. Due to the few clinical signs of these lesions, a thorough ocular study is recommended in these patients.
Enfermedades infecciosas y microbiología clínica, 1998
Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which... more Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which has been described in only 25 published cases in the last 15 years. The appearance of serious disseminated forms of tuberculosis is enhanced by the severe immunodeficiency which characterizes AIDS. Four cases are described of disseminated tuberculosis with cutaneous localization clinically described as the acute miliary form. Patients had AIDS and CD4 lymphocyte levels of < 100 cells/mm3. Diagnosis was established in all cases by scraping of cutaneous lesions and direct examination with Ziehl-Neelsen coloration. The 4 patients presented signs and symptoms of disseminated tuberculosis with cutaneous manifestations, without a definite pattern and with localization predominantly on the thorax. Three had BAAR-positive sputum. Multiresistant strains of Mycobacterium tuberculosis were confirmed by antibiogram. One patient infected by a strain sensitive to first-line drugs responded favorab...
Histoplasmosis is an endemic and systemic mycosis, caused by the dimorphic fungus Histoplasma cap... more Histoplasmosis is an endemic and systemic mycosis, caused by the dimorphic fungus Histoplasma capsulatum var capsulatum. Disseminated disease in immunocompromised patients generally results from the reactivation of latent foci after a prolonged period of asymptomatic infection. We report a case of laryngeal histoplasmosis as the unique clinical manifestation of a progressive form of the disease in a patient with advanced HIV/AIDS disease. Histopathological analysis of laryngeal biopsy smears revealed granulomas containing Histoplasma-like organisms. Treatment with amphotericin B followed by itraconazole resulted in complete remission of laryngeal lesions. To our knowledge, this is the third case report of laryngeal histoplasmosis in a patient with AIDS.
Case report and literature review Malignant syphilis is a rare form of secondary syphilis strongl... more Case report and literature review Malignant syphilis is a rare form of secondary syphilis strongly associated with human immunodeficiency virus infection (HIV). This clinical form of the disease is characterized by atypical cutaneous ulcerative and disseminated lesions and systemic compromise that can delay the final diagnosis. There are only few reports in the medical literature about malignant lues in HIV-infected patients. Malignant syphilis should be considered in the differential diagnosis in HIV-infected patients with fever and ulcerative skin lesions. Here we describe a man who developed clinical cutaneous and systemic manifestations pathologically confirmed as malignant syphilis and we performed a review of the literature.
... Report of a case and review of the literature Rubén Solari 1 , Marcelo Corti 1 , Diana Cangel... more ... Report of a case and review of the literature Rubén Solari 1 , Marcelo Corti 1 , Diana Cangelosi 1 , Manuel Escudero 1 , Ricardo Negroni 2 ... are located in the United States along the Mississippi Valley, the Missouri and the Ohio Rivers and in South America, Serra do Mar in ...
Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the sk... more Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the skin with a wide range of clinical manifestations. Commonly, the clinical features of CBCL are plaques, nodules, or ulcerative lesions. Skin is one of the common sites for extra-nodal lymphomas in patients with AIDS and B cell type is less common than T cell type. Only recently, the existence of B cell lymphomas presenting clinically in the skin without evidence of extra-cutaneous involvement has been accepted as primary CBCL. Here, we are presenting 5 patients with cutaneous involvement in the setting of HIV/AIDS disease. Two of them were primary cutaneous non-Hodgkin lymphomas. All were CBCL; 3 were immunoblastic, 1 was plasmablastic, and the other was a Burkitt lymphoma. We analyzed the epidemiological, clinical, virological, and immunological characteristics of this group of patients.
Revista do Instituto de Medicina Tropical de São Paulo, 2008
Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last y... more Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.
Revista da Sociedade Brasileira de Medicina Tropical, 2007
Lymphomas of the oral cavity are a rare complication of advanced HIV/AIDS disease. The clinical a... more Lymphomas of the oral cavity are a rare complication of advanced HIV/AIDS disease. The clinical appearance of these neoplasms includes masses or ulcerative lesions that involve the oral soft tissue and the jaw as the predominant manifestation. We report the case of a patient with AIDS who developed diffuse large B-cell non-Hodgkin's lymphoma of the oral cavity during highly active antiretroviral therapy, with undetectable plasma viral load and immune reconstitution.
Extranodal non-Hodgkin lymphoma (NHL) were commonly described in AIDS patients and are related wi... more Extranodal non-Hodgkin lymphoma (NHL) were commonly described in AIDS patients and are related with an atypical morphology and aggressive clinical course.
Enfermedades Infecciosas y Microbiología Clínica, 2001
ABSTRACT The study evaluates the incidence of ocular compromise in the Kaposi’s sarcoma associate... more ABSTRACT The study evaluates the incidence of ocular compromise in the Kaposi’s sarcoma associated with AIDS. Methods We revised the clinical histories of HIV seropositives patients seen in the ophtalmologie departament from January, (1994) to December, (1998). All patients were examined by direct visually and dilated fundus examination with the use of either a direct or an indirect ophtalmoscope. Results In 6,552 patients, ocular Kaposi’s sarcoma was diagnosed in 17 (0.25%), predominantly in male sex (88.23%). The lesions predominated in eyelids, and the inferior been the most affected. In only one female, the ocular compromise was the first neoplasic manifestation. Conclusions The ocular compromise in the Kaposi’s sarcoma is an alternative to be considered in AIDS patients with previous or simultaneous cutaneous or visceral involvement. Due to the few clinical signs of these lesions, a thorough ocular study is recommended in these patients.
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